Spina bifida patient healthy, happy after fetal surgery

(SACRAMENTO) —

When Esparto resident Chloe MacCullough was pregnant at 25 weeks, her baby was flagged for increased risk of a neural tube defect in a routine screening. A private specialist in Sacramento confirmed by ultrasound that her son had spina bifida low on his back.

“They said his bowels, bladder and legs could be affected,” said MacCullough. “But they also said we might be good candidates of the fetal surgery program at UC Davis. I had no idea that they could do this type of surgery in utero. We said yes right away.”

UC Davis Fetal Care and Treatment Center is the region's first comprehensive multidisciplinary fetal diagnosis and therapy center in inland Northern California. It is currently the region's only choice for on-site fetal surgery, including open fetal surgery for spina bifida, which operates on mother and fetus via an open incision on both.

Remington MacCullough

MacCullough and her husband met with Shinjiro Hirose, a fetal surgeon and director of the center, to discuss the possibility of fetal surgery. After an MRI and amniocentesis ruled out any genetic abnormalities, the team discussed her case in their multidisciplinary meeting and offered her and her unborn baby fetal surgery.

In the two-and-a-half hour surgery, Hirose was able to expose her baby’s spine and with pediatric neurosurgeon, Marike Zwienenberg, they repaired the defect so further damage would not take place in the womb. Surgery was a success.

However, in the days following surgery, MacCullough had complications that required her health care team to schedule a cesarean section (C-section) earlier than planned. Remington MacCullough was born on Sept. 4, 2017, at 27 weeks.

In the Neonatal Intensive Care Unit (NICU) at UC Davis, Remington was moving, kicking and lifting his pelvis off the bed. He didn’t need a shunt placed in his brain, which is sometimes required for spina bifida patients to help drain excess fluid. He also didn’t need a breathing tube. All were very good signs for Remington’s future.

“He’s doing really well now,” said MacCullough. “His leg mobility is great. He’s kicking and wiggling like crazy. He’s right on track with developmental milestones for his adjusted age,” said MacCullough. "We’re really lucky to be so close to Dr. Hirose, who could do this surgery for us. I would tell anyone who is cleared for fetal surgery that they should do it. I was also really impressed with the labor and delivery staff here, the NICU staff, the surgeons. I never felt that I wasn’t being well taken care of.”

Hirose said it is incredibly gratifying to see Remington do so well.

"We had some early setbacks with prematurity, but he overcame that and has become healthy and happy. Remington is a great example of the incredibly high level of multidisciplinary care here at UC Davis and is a testament to the dedication of our team," Hirose said.

UC Davis Children's Hospital is the Sacramento region's only nationally ranked, comprehensive hospital providing care for infants, children, adolescents and young adults with primary, subspecialty and critical care. It includes the Central Valley's only pediatric emergency department and level I pediatric trauma center, which offers the highest level of care for its critically ill patients, as well as a level I children's surgery center. The 129-bed children's hospital includes the state-of-the-art 49-bed neonatal and 24-bed pediatric intensive care and pediatric cardiac intensive care units. For more information, visit children.ucdavis.edu.